EEG use during DBS

Electroencephalography Use
During Deep Brain Stimulation
California Polytechnic State University - San Luis Obispo
Adam Aslam
Charles Aylward
Sara Wier

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Introduction-
Project Goal-
The goal of this project was to investigate electroencephalography use during deep brain
stimulation through the testing and observation of signal patterns in healthy subjects.
Project Aims-
The aims of this project were to research, select and purchase, and start human subject testing
all with the focus on electroencephalography and deep brain stimulation as it applies to
Parkinson’s Disease.
The emphasis of research was to look into what causes the signals picked up by the EEG, the
dominant signals associated with EEG, current literature of EEG use especially associated with
Parkinson’s Disease, and a general knowledge of deep brain stimulation and its applications. In
order to select an EEG system several criteria were generated from previous studies. The criteria
focused on electrode type, number of channels, sampling rate, and price. From the criteria, a
system was selected. Subject testing was not investigated this year, but will extend into next
year as the project continues.
Background Research-
The Brain-
The Lobes of the Brain and Their Functions:
The frontal lobe, located in the anterior part of the brain, is mainly responsible for emotional
control, forming our personality, and influencing our decisions. Other functions of the frontal
lobe include cognition, problem solving, speech, motor skill development, impulse control,
regulating sexual urges, and planning.
The parietal lobe, which mainly functions in processing sensory information for cognitive
processes and spatial reasoning, is located posteriorly to the frontal lobe. More specifically, the
parietal lobe senses pain, pressure, and touch, regulates and processes the body’s five senses,
movement, visual orientation, and speech.
The temporal lobes are located on each side of the brain and mainly process auditory sounds.
Other functions of the temporal lobes include helping to form long-term memories and process
new information, formation of visual and verbal memories, and interpret smells and sounds.
The occipital lobe is located at the very back of the brain and is mainly responsible for visual
processing. Other functions of the occipital lobe include movement and color recognition
(“Lobes of the Brain”).

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Figure 1. Left: each lobe is differentiated by color and location (“Lobes of the Brain”); Right: the subthalamic
nucleus is located beneath the thalamus (Leisman).
Motor Function Control Centers:
The subthalamic nucleus is a component of the basal ganglia and is part of the diencephalon
(Temel). Basal ganglia are collections of neuron cell bodies that receive input from the cerebral
cortex and participate in the organization and guidance of complex motor functions. The basal
ganglia consist of three structures: the caudate, the putamen, and the globus pallidus (Figure 2).
The basal ganglia also transmit signals to other parts of the brain (Figure 2). The basal ganglia
are mainly responsible for initiating and stopping skeletal movements (Purves).
Figure 2. Left: The anatomy and location of the basal ganglia are shown as well as the substantia nigra in the
midbrain. Shown also are the signal transmission pathways. Right: Also shows signal transmission pathways, but
more clearly shows the inputs and outputs of the caudate and putamen of the basal ganglia (Purves).
The cerebral cortex and the lobes of the brain are further broken down into 3 areas that control
nearly all movement. The primary motor cortex is responsible for conscious control of precise
skeletal muscle movements. The premotor cortex controls learned and repetitious motor skills
and helps plan movements. Broca’s area is located in the left hemisphere of the brain usually
and directs the muscles responsible for speech production.

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Figure 3. The locations of the primary motor cortex (red), premotor cortex (blue), and Broca’s area (purple) are
shown (Motor areas of the brain).
Neuron Behavior-
Neuron potentials:
There are three different levels of membrane potentials. The first is the resting potential, which
maintains a value of -70mV while nothing perturbs the cell. The threshold potential, -55mV, is
the value the potential difference of the neuron must reach in order for an action potential to
occur. An action potential is the period in which the cell potential rises and falls quickly to
propagate a neural signal. The peak potential during this time is approximately 30 mV and is the
maximum value the potential reaches during depolarization. The change in potential from
resting to peak depolarization is always approximately 100mV (Shields, “Action Potentials”).
There are two different types of potentials that occur at the post-synaptic cleft or the region
between the axon terminal of one neuron and the dendrites of another neuron. The first type is
known as an excitatory postsynaptic potential (EPSP) and is when the net influx of sodium ions
is greater than net influx of potassium ions and a depolarization occurs that leads to an action
potential. The second type is an inhibitory postsynaptic potential (IPSP) in which channels open
for potassium and chlorine ions making the inside of the neuron more negative which inhibits
the formation of an action potential (Shields, “The Synapse”).
Potentials can also interact with one another in three ways. Temporal summation occurs when
EPSPs close in time add together resulting in one excitatory postsynaptic potential of greater
value. A spatial summation occurs when simultaneous stimulations at two different locations
can cause EPSPs that add together also resulting in an excitatory postsynaptic potential of
greater value. EPSPs and IPSPs can also summate and cancel each other out resulting in no
change in cellular potential (Shields, “The Synapse”).

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Figure 4. Diagram showing the potential changes during depolarization of a neuron (Aqra).
Signal speed:
The speed of signal is influenced by axon diameter and the amount of myelin a neuron
possesses. The larger the diameter of the axon, the less resistance to local current flow there will
be, which results in faster signal conduction. Myelin is a sheath that surrounds certain types of
axons. More myelin results in faster conduction because the signal jumps over the myelin
sheaths to gaps between the sheaths called Nodes of Ranvier, which shortens the distance the
signal has to travel and thus cutting the time it takes for the signal to reach its destination. This
is known as saltatory conduction (Shields, “Histology of Nervous Tissue”).
Depolarization:
While each neuron is resting, they maintain a cell potential of -70mV with a more negative
interior than exterior. This potential is regulated by passive or leaky potassium ion channels if
left by themselves would create a resting potential of -90mV. To establish the normal resting
potential the neurons also utilize sodium-potassium pumps, which use energy in the form of
ATP to pump three sodium ions out of the cell and two potassium ions into the cell.
The process of depolarization begins with a stimulus, which could come from a conformational
change in a peripheral neuron receptor or from the transmission and reception of
neurotransmitters within the brain. This stimulation could also be caused by an applied
electrical stimulus as with DBS. Once the stimulus reaches a neuron, the chemically gated
sodium channels open up on the pre-synaptic dendritic endings of the neuron allowing sodium
ions to flood into the cell. This is called a graded potential, which travels down the dendrites
through the cell body to the beginning of the axon known as the axon hillock. The influx of
sodium raises the potential. If the potential does not reach -55mV at this point, the cell only
experiences the graded potential, an impulse that travels a smaller distance and does not
stimulate any other neurons. However, if the cell potential reaches -55mV or above, an action
potential propagates and is known as depolarization.
This propagation occurs as the sodium ions increase the amount of positive charge within the
cell and as the positive charge travels down the cell from the axon hillock, it causes the opening

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of more sodium channels. Once the cell reaches its maximum potential of 30 mV, potassium ion
channels begin to open to allow the flux of potassium from within the cell. This begins to lower
the potential of the cell to return it to resting potential after the impulse has travelled by the
axon hillock and has begun to propagate down the axon.
Hyperpolarization occurs when the membrane potential becomes more negative than the resting
potential. This happens because the voltage gated sodium channels along the axon become
inactivated when the impulse passes them and the potassium ion channels remain open and
close more slowly. This is also called the absolute refractory period, which ensures that the
signal only propagates in one direction. This allows more positively charged potassium ions to
leave the cell than can enter through the only available leaky potassium ion channel thus
causing the charge within the cell to drop and the charge outside the cell to increase.
Once the potassium ion channels close, the voltage gated sodium channels reset and the resting
membrane potential is reestablished through leaky potassium ion channels and the sodium
potassium pump (Shields, “Action Potentials”).
After the signal travels through the axon, it reaches the terminal dendritic endings of the neuron
or what is known as the post-synaptic cleft. When the action potential propagates to this area,
voltage gated calcium channels open and synaptic vesicles release the neurotransmitter by
exocytosis. This neurotransmitter travels across the gap between the postsynaptic cleft of this
one neuron to the pre-synaptic cleft of another neuron where the neurotransmitters bind to
chemically gated sodium receptors and start another action potential (Shields, “The Synapse”).
Movement Disorders and Treatment-
Movement Disorders are conditions that can be disabling and very difficult to manage. The
most common movement disorder is ET. ET is a progressive disease that is often inherited and
begins later in adulthood. Patients experience tremors due to the brain sending abnormal signals
to muscles. The areas of the brain that the signals move through before reaching muscles are the
cerebellum, nucleus ruber, globus pallidus interna (GPi), thalamus, and cortex (Types of
Movement Disorders).
Another common movement disorder is PD. Patients can suffer from tremors, muscle rigidity,
bradykinesia, and depression among other symptoms. The cause of PD is unknown, but the
symptoms are known to be caused by the loss of cells in the substantia nigra. This area produces
the neurotransmitter dopamine, which is involved with muscle movement and motivation
(Types of Movement Disorders). When the substantia nigra is deteriorated, the subthalamic
nucleus (STN) becomes overactive, which affects the GPi. The GPi being overstimulated leads
to thalamic inhibition, thus tremor. When the GPi is slowed, motion and rigidity begins to shut
down (Espay).
ET patients sometimes choose to take medications such as Primidone or Propranolol. Most
medications that PD patients use aim to replace lost dopamine. Physical therapy and exercises
have been known to improve symptoms as well (Types of Movement Disorders).

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Deep brain stimulation is a relatively recently developed technology that has had a drastic effect
on the symptoms of many PD and ET patients. In DBS, a lead is implanted in the brain, usually
in the thalamus, STN, or the GPi (Browner), which is then connected to an implanted pulse
generator that contains the battery and circuitry required to generate the stimulation pulses. The
generator is implanted beneath the skin in the upper portion of the chest and connected by wire
subcutaneously to the DBS lead in the brain.
Figure 5. From left to right: Thalamus implantation of DBS stimulator, GPi implantation of DBS stimulator, and
STN implantation of DBS stimulator (Browner).
Components of an EEG System-
EEG systems are comprised of electrodes, amplifiers, filters, analog to digital converter, and a
recording device. Data flows from activity within the brain to the electrodes placed on the scalp
in the microvolt range. Amplifiers and filters boost the signal to a range that can be accurately
converted to digital data. The analog to digital converter then converts the signal to be read and
displayed by a recording device, such as a personal computer.
Neural activity in the brain results in changing potentials measured between a signal electrode
and reference electrode. A third electrode (placement irrelevant) is used to ground the system.
This general configuration of electrode is referred to as a montage. There are two types of
montages: bipolar and referential. In the bipolar montage there are two electrodes used per
channel. One electrode is used to perceive the potential difference and the other is used as a
reference electrode. The referential montage uses one common reference electrode for all
channels (EEG: Introduction). The electrodes are critical in obtaining high quality data for
interpretation.
Types of electrodes include disposable electrodes (often used with gel), reusable disc electrodes
(gold, silver, stainless steel or tin), headbands/electrode caps, saline-based electrodes, and
needle electrodes. Multi-channel EEG analysis favors the electrode cap as it places electrodes
all around the surface of the scalp. Electrodes in the cap are commonly made of 1-3 mm
diameter Ag or AgCl disks with a long flexible lead to connect to an amplifier. AgCl electrodes
provide accurate recording in very slow changes in potential. Needle electrodes penetrate

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through the scalp, which can cause irritation or pain for the user and are thus best used only for
long duration readings.
Skin preparation prior to mounting the electrodes involves cleaning the skin surface of dried
parts and oils. The space between the electrodes and the skin should be filled with a conductive
paste to lower the impedance between the skin and electrodes as well as help the electrodes
stick. Cap systems often provide small holes to inject the conductive paste (EEG: Introduction).
In some systems, dry electrodes are used for convenience. These do not require the use of
conductive paste, which minimizes preparation and clean up time. The performance of these
systems has been shown to be as effective as commercially available wet electrodes (Taheri).
Due to the low amplitude of the signals naturally created in the brain, amplifiers are required to
gain the signals to levels usable by devices such as converters and displays. Specific
characteristics of amplification must be met to selectively acquire the physiological systems and
reject noise. Overwhelming interference can damage other components as the gain may boost
the signals (surge) past maximum ratings. Biopotential amplification must meet several basic
requirements to preserve the natural signal and protect the monitored patient. There must be
protection for the system components and patient to prevent harm from surges or high input
voltages. The physiological process must not be influenced in any way by the amplification and
the signal must not be distorted. During measurements, the amplifier will pick up signals from
the desired biopotential, undesired biopotentials, power line interference signal or 60 Hz (and
harmonics), interference signals generated by the skin-electrode interface, and noise. Proper
design eliminates the majority of the interference signals (EEG: Introduction).
Important EEG System Specifications:
Frequency bandwidth: Approximately 1Hz to 50 Hz. This range would capture the range of
useful EEG, from beta waves to gamma waves (Malmivuo).
Sampling Rate: The rate of data acquisition ranges from 20Hz to 20,000Hz depending on the
system. Faster sampling rates allow for the analysis of high frequency signals and more accurate
readings of ERPs or event related potentials.
Number of channels: Depending on the application, the number of necessary channels can
range from 2 to 256. A study looking into effective numbers of channels found that in a 256
electrode cap, on average only 125 gave useful results due to movement artifacts and poor
electrode to scalp connections (Lau). Studies involving motion have been successful looking at
as few as 2 strategically placed electrodes.

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Standard filters: Less than 1 Hz (high pass filter) and 50 Hz (low pass filter) (EEG:
Introduction).
Electrode Material: Ag/AgCl is a commonly used material in many clinical EEG applications.
Electrode placement: Standard locations such as 10/20, 10/10, or 10/5 placement (EEG:
Introduction). The first number refers to the front-to-back electrodes being placed with 10% of
the total length in between each other. The second number refers to the side-to-side percentages
of total length. The standard 10/20 placement has been improved upon in the 10/10 and 10/5
placements, which have more electrodes (Oostenveld and Praamstra).
Impedance (resistance to current flow): 100 ohms to 5000 ohms (EEG: Introduction).
.
Figure 6. 10/20 placement of electrodes on the scalp. Each letter preceding the numbers indicates the lobe of the
brain on which the electrode is placed. The number refers to the location (odd numbers being on the left side of the
brain, even numbers on the right). Also shown are the placement of two reference electrodes, in this case, on the
ears (A1 and A2) (EEG: Introduction).
EEG Signals-
EEG shows a graphical representation of voltage differences between two cerebral locations
over time. The majority of the contribution to EEG is from synaptic voltages. This means the
summation of both EPSP’s and IPSP’s between cortical neurons are included in the EEG
(Olejniczak).
There are five classifications of EEG signals. From lowest frequency to highest frequency, the
waves are as follows: delta, theta, alpha, beta, and gamma waves. Delta waves have a frequency
less than or equal to 3 Hz and dominant rhythms that occur in infants and in stages three and
four of sleep. These waves occur frontally in adults and posteriorly in children. Theta waves
have a frequency between 3.5 and 7.5 Hz. These waves are abnormal in people who are awake
and over the age of 13. Alpha waves have a frequency of 7.5 to 13 Hz. They are best observed

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in posterior regions of adults and are higher in amplitude on the dominant side. These waves are
present during relaxation periods such as closing of the eyes. Beta waves have a frequency
greater than 14 Hz and they occur equally on both sides of the brain in the frontal region. These
waves are dominant in people who are alert, anxious, or have their eyes open (EEG:
Introduction). A fifth category, Gamma waves, has a frequency between 30 Hz and 50 Hz
(Jirayucharoensak). Although gamma waves are commonly seen in EEG, there is speculation as
to whether they can be distinguished from artifact using an EEG machine. Artifact due to eye or
limb movement can be easily mistaken for brain activity in the gamma frequency range
(Whitham).
Figure 7. Amplitude over a period of about 2 seconds for each major wave frequency class (EEG:
Introduction).
Epilepsy, PD, DBS, and EEG Systems-
EEG systems have been mostly used for diagnosis of Epilepsy and other seizure causing
disorders, even for seizures caused by aneurysm (Selvaraj). EEGs have also been used to study
anxiety disorders, depressive disorders, co-morbid addiction, attention-deficit/hyperactivity
disorder, and brain injury (Simkin). EEG devices have been utilized along with
electrooculography, and electromyography (EMG) devices to diagnose sleeping disorders
(Kaplan). One study used EEG to monitor effects of transcranial direct current stimulation
(tDCS) and investigate the feasibility of using both the EEG system and the tDCS system
simultaneously. tDCS is a non-invasive form of DBS and applies stimulation to the skull and
more specifically in this study to the left sensorimotor cortex (Roy). EEG systems are also being
used to diagnose patients with frontotemporal lobar degeneration (FTLD), a form of dementia
characterized by alteration in personality and social behaviors and is associated with atrophy in
the frontal and temporal brain regions. Before this study was done, FTLD was difficult to
diagnose with the pre-existing algorithms to interpret the EEG wave activity, but through this
study, non-linear algorithms were developed that led to more determinate diagnosis (Carlino).
PD is caused by the degradation of dopamine releasing neurons, which deprives the basal nuclei
of dopamine causing them to become overactive in turn causing tremors at rest and slow
movements. PD causes a degradation of the area of the midbrain known as the substantia nigra.
The substantia nigra acts as a source of input information into the caudate and putamen of the
basal ganglia. The caudate and putamen then transmit the signal to the subthalamic nucleus
(Purves).

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DBS is usually applied at a frequency of around 130Hz and has two methods of administering
stimulation. The first, known as closed loop stimulation delivers electrical pulses in the pattern
of firing neurons. The second method was known as open loop stimulation, which delivered
normal, continuous, high voltage stimulation to the brain. Both methods were tested first on
primates, and then on humans. Closed loop stimulation used the presence of beta bursts, or high
frequency beta waves, to determine when and how long the stimulation should occur. When a
beta burst was detected, the device delivered stimulation until the beta waves dropped below the
trigger frequency, after which stimulation stopped. The study reported that this method of DBS
reduced stimulation time by 56% and clinical improvement increased by 30% (Little). The beta
wave frequency was determined directly from the DBS electrode. This particular study did not
focus on the alteration of beta waves due to DBS, but focused on the frequency of beta waves to
determine when to administer DBS stimulation with the closed loop system. (Little).
EEG Systems Used in Relevant Studies-
In a study used to relate brain waves during painful stimulation to waves during non-painful
stimulation, a 19-channel EEG system was used using the 10/20 standard placement of
electrodes. Referential montage was also used with reference electrodes on the earlobes and a
sampling rate of 500 Hz (Chien).
As of 2011, there was no way to record EEG during DBS treatment because of stimulation
artifact overlapping with useful EEG. A common practice for collecting data during DBS
stimulation was to record EEG just after DBS was shut off, and observe the patient’s transient
response. It was found that by Hampel filtering, the artifact could be separated out. This filter
uses the fast Fourier transform (FFT) to replace outliers in the frequency domain with
interpolated values, then using the inverse FFT to transform back into the time domain. This
allows EEG to be recorded during DBS by reducing stimulation artifact. EEG in this study was
observed using a 72 channel “EasyCap” using 10/20 placement. Collection of EEG was made
with a Neuroscan SynAmps sampling at 1 kHz and processed in Matlab (Allen).
Dr. Harrison Walker of the University of Alabama studies DBS applied to PD, dystonia, and
ET. A 16 or 24 channel Nihon Kohden EEG system was initially used, with a sampling rate of
10 kHz. To obtain better readings, Dr. Walker has switched to a Brain Vision device with 64
channels and active electrodes, which means that the amplifier is built into the electrode,
minimizing artifact noise and improving signal quality. An important aspect of an EEG device
is the capacity to sample at a fast rate. Slower sampling rates amplify the size of the noise,
producing worse quality EEG signals. The study by Dr. Walker is especially relevant due to its
similarity to the topic of this review. Dr. Walker used EEG to observe cortical response to DBS
in multiple patients. Dr. Walker originally removed DBS artifact by reversing the anode and

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cathode on the DBS electrode, which inverted artifact and was then removed. Dr. Walker has
since moved onto using bipolar pairings to eliminate DBS artifact. This means adjacent EEG
electrodes are compared to each other, effectively eliminating DBS signal. Sampling at about 10
times the highest frequency observed is enough, unless looking at latency or to minimize DBS
artifact. His experiment was successful in determining that “effective high frequency
subthalamic DBS for PD is associated with synchronization of cortical neurons at the
stimulation frequency or one of its subharmonics” (Walker). Specifically, it was found that
neurons in cerebral cortex discharge at one millisecond after the stimulus pulse (Walker).
It is important to note that use of EEG in DBS patients can result in skewed data. Since there is
a hole in the head of the patient, changes in ERPs and EEG must be accounted for. This has
successfully been done, and is seen in studies using EEG (Oostenveld and Oostendorp).
Another study found that by using a simple mean squared error, DBS artifact could be removed
from useful EEG. This study described different methods that have been used to separate DBS
from useful EEG, such as an offline low pass filter or a bandpass filter online and a low pass
filter offline (Sun).
The evoked potentials of PD patients are often slowed, meaning neurons take longer to respond
to stimuli. This was shown in a study in which patients responded to auditory signals. EEG was
taken both with DBS on and off and the time it took the brain to respond to the 70 dB trigger
was recorded. The study used a 64 channel EasyCap with active electrodes. The BrainAmp
amplifier sampled at 1 kHz and signal was processed using Matlab, EEGLAB, and FieldTrip
software. Seven electrodes, side-to-side with the Cz electrode were used for analysis because
cable movement, blinking, swallowing, or muscle artifact didn’t largely affect them. A bandpass
filter of .016 to 250 Hz was used (Gulberti).
Beta waves have been studied as they relate to PD and the effect of DBS on such patients. Beta
frequencies, which are centered around 20 Hz are recorded as normal activity for healthy
people. Stronger beta waves occur when neural activity becomes synchronized over time and
signals summate to produce a larger amplitude beta wave. One study has related beta waves to
movement and has supported the mechanistic role of beta waves in the pathophysiology of PD.
Beta waves in the study were shown to represent neural firing due to movements. The firing
was suppressed due to warning cues predicting upcoming action and beta waves were higher
and augmented by the holding of movements and by stopping pre-planned movements. Beta
waves were classified as being responsible for slowing of spontaneous movements and postural
correction or also maintaining status quo. Patients with PD, especially those who were taken off
of dopaminergic medications, were seen to have much higher amplitude beta wave activity
which limits information coding capacity so that novel processing is impaired and the status quo
formed over new movements resulting in bradykinesia, which is the slowing of movements or

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the inability to adjust the body’s position. Because of this, beta waves are thought to be
controlled by the level of dopaminergic activity in response to internal and external cues and
serve to modulate the stability of the current motor state (Little).
In a study involving finger movement, the C3 and C4 electrodes on healthy subjects were
analyzed. Asking subjects to keep their eyes closed and to be as relaxed as possible without
falling asleep minimized artifact and unwanted results. In this study, only two of the electrodes
out of the 41-electrode cap were crucial for observation A BrainScope EEG was used, sampling
at 256 Hz. An Isotrak II 3D scanner helped to place the electrodes at the desired locations
(Stastný).
Another study looked into the possible use of DBS in the pedunculopontine nucleus for PD
patients. They found useful results from ankle and wrist movements by analyzing the Fp1, Fz,
Cz, C3, C4, CP3, and CP4 electrodes and sampling at 1 kHz. Two frequency bands, theta (6–10
Hz) and beta (14–30 Hz), contributed to changes in movement in the C3/CP3-C4/CP4 and Fz-
Cz range (Tsang).
System Selection-
System Requirements-
Requirement Value
Active electrodes The system must have active electrodes to minimize the
noise artifact
Fast Sampling Rate ≥ 2000 Hz
MatLab Compatible It would be nice if the system were compatible with
MatLab for signal analysis
Price ≤ $20,000
Channels ≥ 32 channels
Table I. The above system requirements were generated based off of other EEG systems used in other relevant
studies.
The requirements were developed from recommendations taken from other relevant studies as
well as from a well-known researcher, Harrison Walker, who is familiar with EEG systems.
Active electrodes, as recommended by Walker, minimize the noise artifact in the acquired data
signal by possessing a second amplifier within them. A faster sampling rate allows for analysis
of higher frequency signals and a more accurate reading of action potentials. The higher number
of channels allows for a more accurate reading of the exact location of ERPs by covering a
larger surface area of the head. And since the team is familiar with MatLab, it would be best to
get a system compatible with that software in order to easily analyze the data.

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Some systems that met the majority of our requirements were: NeuroScan- Synamps 2 RT/64,
Biosemi- ActiveTwo, Brain Products- ActiCHamp, Cognionics- Wireless 64, ANT Neuro-
Asalab 64, and EGI- Geodesic 400. Some less expensive amplifiers were also explored, but
with these systems, the cap had to be purchased separately. Some of the amplifiers considered
were: Mitsar- 202-31, BrainMaster- Discovery 24E, Advanced Brain Monitoring- B-Alert X24,
and Natus- Nicolet v32. Some of the stand-alone caps considered were: ANT Neuro-
Waveguard, BrainMaster- ElectroCap, Brain Products- Acticap, BrainVision- BrainCap, and
Easycap- eascycap Active.
All systems were compared using the requirements above:
Brain Products BioSemi Cognionics Neuroscan
ANT
Neuro EGI
Model ActiCHamp ActiveTwo Wireless 64
Synamps 2/RT
64 Asalab 64 Geodesic 400
Sampling Rate (Hz) 25000 8192 500 20000 4000 8000
Active Electrodes Yes Yes Yes No Yes No
Gel/Dry Gel Gel Dry Gel Gel Gel
MATLAB Yes Yes Yes Yes Yes Yes
Channels 64 64 64 64 64 64
Electrode Layout 10/20 10/20 10/20 10/20 10/20 10/20
Price ($) 39900 32000 40445 -- 28K-56K --
Table II. The systems all evaluated above include both an amplifier and cap. All systems with missing pricing
information indicate that pricing information was unavailable.
Amplifiers Mitsar BrainMaster Advanced Brain Monitoring Natus
Model Mitsar 202 31
Discovery
24E B-Alert X24 Nicolet v32
Sampling Rate (Hz) 2000 512 256 12000
MATLAB Yes Yes Yes Yes
Channels 32 24 24 32
Price ($) 10500 5800 -- --
Table III. The systems above only consist of an amplifier. If the amplifier is listed without pricing information that
means that pricing information was unavailable for that product.

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Table IV. The products listed above are all electrode caps for EEG. If the price is not listed for the cap the pricing
information was unavailable for that product.
All of the systems in Table I were listed in tier 1, which classified them as being all
encompassing systems, but also the most expensive systems. The next two tables layout cheaper
systems, but Table II only contains amplifiers and Table III only contains electrode caps. All
systems follow the 10/20 electrode placement guidelines. Most systems require conductive gel
for the electrodes and are MatLab compatible.
The selected EEG system consisted of the Mitsar 202-31 amplifier and the Brain Products
actiCAP electrodes and cap. We selected this combination of devices because they met the
majority of our requirements. Major considerations when choosing these two devices were the
use of active electrodes and MatLab compatibility. The sampling rate was not quite as high as
desired, but for our applications, the sampling rate of 2000 Hz seemed sufficient. Another major
component was the cost. The MatLab compatibility turned out to be a great thing because this
allowed for the incorporation of EEGLab and WinEEG data analysis software.
Protocol-
Objective-
This study involves the use of an electroencephalography (EEG) system to measure brain signal
data from healthy subjects. Our interest is to analyze this EEG while subjects perform tasks that
are difficult for patients with movement disorders such as Parkinson's Disease. Our hope is that
results can then be used to give more insight on the function of deep brain stimulation in
movement disorder patients.
Materials-
EEG systems consist of a cap, electrodes, recording circuitry, and connecting wires. We will be
using the Mitsar-EEG 202-31 system with a 10/10 layout, which has 31 channels and a 2000 Hz
sampling rate. This system includes the amplifier, a USB cable, a power supply unit, and
WINEEG data analysis software. The cap and electrode system used will be a 32-channel
BrainProducts actiCAP with active electrodes. This also comes with the SuperVisc gel that is
used to increase conductivity at the electrode. An external device such as a camera or
accelerometer will be used simultaneously with the experiment in order to mark the time of the
Caps ANT Neuro BrainMaster Brain Products BrainVision Easycap
Model Waveguard ElectroCap actiCAP BrainCap Easycap Active
Active Electrodes Yes No Yes No Yes
Electrode Layout 10/20 10/20 10/20 10/20 10/20
Price ($) -- 475 -- -- --

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action on the signal. For use in our tests seen in the Methods section, we will use paper cups,
pencils, and binder paper.
Methods-
The 18-24 year old students being studied will be asked for basic demographic information,
including age, sex, race, and relevant health history. Before testing begins, the subject will be
asked to review and sign the informed consent form, and any questions that he or she has about
the study will be addressed. The subject will be told that they have the option to opt out of the
study at any time.
The study will take approximately 1 hour to complete. The first step is EEG system setup,
which includes placement of the EEG cap and will take 10-15 minutes total to complete. The
camera will be set up to view the subject's upper body, head, and the table in front of him/her.
At this time, an optional accelerometer may also be set up in the appropriate location. The setup
of the EEG includes adjusting the electrode cap to fit the user’s head and injecting the
conductive gel. The subjects will then be asked to relax and sit still for 2 minutes. Each test will
have the subject wait for a verbal cue to begin the indicated activity. A research supervisor will
begin a timer at the start of each test. During each test, subjects will be asked to avoid blinking
or moving, other than that required for the test.
1. Pencil Pickup Test
The first test has the subject reach for an object placed on a table within arm’s reach.
The subject will be asked to sit comfortably with his/her arms resting on the table. Then
he/she will reach for a pencil on the table, pick it up, and place it back on the table. This
test will be repeated five times by each subject with 20 seconds between each test.
2. Writing/Drawing Test
This test looks into writing/drawing. The subject will be given a pencil and binder paper
to write their name repeatedly for 30 seconds and then stop for 10 seconds. The subject
will then be asked to draw an outwardly expanding spiral for 10 seconds. This will be
repeated 3 times with 20 seconds between each test.
3. Swallow Test
This test has the subject take sips of water from a paper cup. We are looking at the
swallowing action, so the subject will be asked to remain still with a small amount of
water in their mouth for 2 seconds before swallowing. This will be repeated 5 times with
20 seconds between tests.
4. Stand Test
This test has the subject stand up. He/she will be asked to stand up for 5 seconds after
being verbally prompted. We will attempt to keep all wires and other parts stationary

17
since we expect noise to interfere with our signal. We will ask the subject to perform
this task 5 times with 20 seconds between each test.
5. Postural Tremor Test
This test has the patient hold their dominant arm parallel to the floor and pause for 5
seconds. With their arm held out, the subject proceeds to rotate their wrist alternating
between facing the hand up and down for 10 seconds. This test will be repeated 5 times
with 20 seconds between each test.
6. Bradykinesia Test
This test has the subject place their arm on a table and tap their thumb to their index
finger. The subject will sit at rest with their arm resting on the table. Once verbally
prompted, the subject taps their thumb to their index finger 10 times at 1-second
intervals using a stopwatch for assistance. This test will be repeated 5 times with 20
seconds between each test.

Once the testing is finished, the cap will be removed, which will take roughly 5 minutes.
Subjects will be advised to wash out the conductive gel using water and shampoo.

Each measurement will begin with the subject at rest and continue through the duration of the
exercise. A new sample is recorded for each test including repeated tests. The aim of the
recordings at different conditions is to determine characteristics of the EEG while the subject is
at rest, and changes that occur with typical voluntary motions or actions. These tests represent
the control group, which serves as a baseline for the tasks performed. Data that will later be
conducted on patients with Parkinson's Disease can be compared to this control group.

Data Interpretation-

The 32-channel EEG being used will follow the standard 10/10 electrode layout. The number of
electrodes acquiring signals provides sufficient freedom to observe responses in different
sections of the brain during the tests. The focus of the tests performed in the experiment
procedure will be on movement related activity. The corresponding electrodes used for analysis
will be primarily in the C, F and P regions of the 10/10 scheme and will vary depending on the
activity performed by the subject.
The EEG manufacturer software will manage the signal acquisition from the EEG electrodes.
Raw signals will be analyzed using Matlab with the EEGLAB Toolbox. The acquisition
software provided by the EEG manufacturer, EEGStudio, provides filtering of common noise
signals including the power frequency (50Hz). EEGStudio also provides adjustment of
individual electrode sensitivity and filtering. The preprocessed data obtained from EEGStudio
can then be exported to a Matlab compatible file format for extended analysis. EEG signals
existing in the time domain will be converted to the frequency domain using Fast Fourier
Transform techniques provided by the EEGLAB software to observe the power spectra
produced by each activity. The power spectra will be observed to identify signal peaks of
interest associated with each movement related activities. Subject data will then be compared to
find peak frequencies common to multiple subjects. Further analysis will include spatial
filtering to produce a scalp map of peak signals during the activities with the help of the
EEGLAB software.

18
Data for each subject will be stored anonymously using the following format: “EEG15A” to
represent EEG data from subject ‘A’ taken in the year 2015. Any publication or distribution of
the data will not reveal name or any identifying information about any of the subjects.

Discussion and Future Considerations-
System Limitations and Challenges-
Several issues arose once we received the EEG system. The first was that the amplifier only
possessed a European outlet plug. We were able to solve this issue quickly, however when we
realized that the Acticap had 32 electrodes with one reference and the Mitsar amplifier only had
31 channels with two references, our biggest issue started to take shape (Figure 8). Because the
cap was discovered to follow a 10/10 layout instead of a 10/20 layout, the electrode labels on
the cap also did not match up with the labels on the amplifier. We did our best to make sense of
the product differences in order to take recordings from our first subject, but once we looked
into the electrode placement a second time we realized we needed to reconfigure the montage
within the software as well as the electrode order plugged into the amplifier.
Figure 8. Left: the 31-channel Mitsar EEG amplifer system (Mitsar EEG 202 32 Channel). Each electrode from the
cap has a connector that should correspond and plug into one of the channels on the amplifier. Right: the electrodes
on the actiCAP and their corresponding locations (Downloads AcitCAP). Our problem originated because the
labels on both systems don’t match up and the cap has more electrodes than the amplifier has channels.

19
We used online literature as well as the layout charts provided with the cap to create a montage
that conceptually matched the electrode placements on the scalp. This process consisted of
calculating each angle for which each electrode was placed in terms of two separate angles, θ
and Φ. θ being the angle of counter clockwise rotation with Cz representing the origin. Φ is the
elevation of each electrode with respect to the z-axis through Cz as well (Figure 9). Through
this process we were able to create a new montage to analyze data. We also replaced the A1 and
A2 reference electrodes, which are usually placed on the ears, with two actively recording
electrodes, which were considered to be the two mandible electrodes, TP9 and TP10. With this
issue mostly solved we hoped to shift the focus of the project to testing on human subjects.
Figure 9. Shown is a representation of the reference angles, θ and Φ, which were used to correctly locate each
electrode on the acitCAP in order to create our custom montage (EMEGS).
Future Directions-
As the year closes out, the main focus for this project for the future is to collect a large amount
of data from human subjects. The data will then be analyzed and observed for the presence of
any patterns. Looking far into the future, the EEG system and protocol could also be utilized to
test subjects with Parkinson’s Disease and/or Deep Brain Stimulators.
Φ (phi)
θ (theta)

20
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24
Appendix:
IRB Forms-
Informed Consent Form
INFORMED CONSENT TO PARTICIPATE IN A RESEARCH PROJECT,
"Electroencephalography Measurement During Motor Tasks"
Adam Aslam, Charlie Aylward, and Sara Wier, students in the Department of
Biomedical Engineering at Cal Poly, San Luis Obispo, under the supervision of Dr. Kristen
Cardinal, are conducting a research project studying brain signals in healthy subjects. The
purpose of the study is to measure brain activity in healthy individuals performing daily motor
tasks, in order to observe relationships between brain activity and movement.
You are being asked to take part in this study by allowing the researchers listed above to
record brain signals while you perform daily tasks such as lifting a pencil or holding your arms
in certain positions. You will be asked to wear an electroencephalography (EEG) recording cap,
which is placed on your head like a helmet and is connected by wires to recording equipment in
order to measure brain activity. The EEG merely collects the electrical activity produced by
your brain and then displays this on output devices. Conducting gel will be added between the
cap and your hair or scalp to improve signal quality. Your participation will take approximately
1 to 1 ½ hours. Please be aware that you are not required to participate in this research and you
may discontinue your participation at any time without penalty.
The possible risks associated with participation in this study include minor discomfort
due to the electrode cap or the conducting gel, and a very minor risk of low voltage electric
shock due to static electricity. If you should experience any discomfort or emotional distress,
please be aware that you may contact the Cal Poly Health Center at (805) 756-1211 or Cal Poly
Counseling Services at (805) 756-2511 at any time for assistance.
Your confidentiality will be protected by maintaining restricted access to each subject’s
personal information and study data. Also, an anonymous patient identifier will be used in place
of your name or any other identifying information in study documents. Your name will not be
used in any reports of this research without your permission.
Your participation may help contribute to an understanding of brain function. In addition,
you will be offered $25 at the end of the data collection period.
If you have questions regarding this study, please feel free to contact Charlie Aylward,
Adam Aslam, or Sara Wier at eegcalpoly@gmail.com or at (805) 756-2675. If you have
concerns regarding the manner in which the study is conducted, you may contact Dr. Steve
Davis, Chair of the Cal Poly Human Subjects Committee, at (805) 756-2754,

25
sdavis@calpoly.edu, or Dr. Dean Wendt, Dean of Research, at (805) 756-1508,
dwendt@calpoly.edu.
If you agree to voluntarily participate in this research project as described, please
indicate your agreement by signing below. Please keep one copy of this form for your reference,
and thank you for your participation in this research.
____________________________________ ________________
Signature of Volunteer Date
____________________________________ ________________
Signature of Researcher Date

26
HUMAN SUBJECTS PROTOCOL APPROVAL FORM
Cal Poly, San Luis Obispo
All Cal Poly faculty, staff, and student research with human subjects, as well as other research involving
human subjects that is conducted at Cal Poly, must be reviewed by the Cal Poly Human Subjects
Committee for the protection of human subjects, the researchers, and the University. Human subjects
research is defined as any systematic investigation of living human subjects that is designed to develop
or contribute to generalizable knowledge. While the ethical guidelines for research are applicable to
classroom activities, demonstrations, and assignments, the Human Subjects Committee does not review
classroom activities unless data will be collected and used in a systematic investigation.
Researchers should complete all items on this approval form and submit it, along with a research
protocol (containing the information detailed in Guidelines for Human Subjects Research Protocol), to
the Office of Research and Economic Development (Debbie Hart, Bldg. 38, Room 154). Please feel free
to attach an additional page if your responses to any of the items require more space. Your answers to
the items on this form, as well as the research protocol, should be typed. The Committee will make every
effort to respond to your submission within two to four weeks. Committee approval should be received
prior to contacting prospective subjects and collecting data. Please read carefully Cal Poly's Policy for
the Use of Human Subjects in Research prior to completing this application.
If you require assistance in completing this form,
contact the Office of Research and Economic Development at (805) 756-1508.
February 4, 2015 3. Type of Research:1.
Date: Senior project
2. Title of Research Project: Master’s thesis
Faculty research
X Other:
Electroencephalography measurement
during motor tasks
please explain: MEDITEC
Research Project
4. Name(s) of Researcher(s)
Principal Investigator: Charlie Aylward
Department or other
affiliation:
Computer Engineering
Phone: (530) 774-6696 Email: caylward@calpoly.edu
Positio
n:
Faculty X Student
Other: Please explain
Additional
Researcher:
Adam Aslam

27
Department or other
affiliation:
Mechanical Engineering
Phone: (925) 336-7603 Email: aaslam@calpoly.edu
Positio
n:
Faculty X Student
Additional
Researcher:
Sara Wier
Department or other
affiliation:
Biomedical Engineering
Phone: (406) 750-3526 Email: swier@calpoly.edu
Positio
n:
Faculty X Student
Any additional researchers involved in the project should be listed with the descriptive
information requested above on a separate sheet.
5. Faculty Advisor (if applicable)
Name
:
Dr. Kristen Cardinal Email
:
kohallor@calpoly.edu
Department or other
affiliation:
Biomedical Engineering
Department
Phon
e:
(805) 756-2675
Other thesis committee members if the research is a thesis:
Name
:
Email
:
Department or other
affiliation:
Phon
e:
Name
:
Email
:
Department or other
affiliation:
Phon
e:
Name
:
Email
:
Department or other
affiliation:
Phon
e:
6. Is there an external funding source for the project:
X Yes, and the source St. Jude Medical and MEDITEC budget

28
is:
No
7. Is this a modification of a project previously reviewed by Cal Poly’s Human Subjects
Committee?
Yes, and the approximate date of the last review
was:
X No
8. Estimated duration of the project:
Starting date: 3/15/2015 Completion
date:
3/15/2016
9. Describe any risks (physical, psychological, social, or economic) that may be
involved.
See Specific Ethical Criterion #1 in Policy for the Use of Human Subjects in Research for a description of the
types of risks.
1) There is a slight risk of discomfort due to wearing the EEG electrode cap and
conductive gel.
2) There is a very minor risk of possible low voltage electric shock generated by the EEG
measurement hardware or from static electricity.
10. Indicate what measures will be taken to minimize risks. See Specific Ethical Criterion #1 in
Policy for the Use of Human Subjects in Research for a discussion of strategies for minimizing risks.
1) The EEG system safety guidelines specified by the system manual will be precisely
followed.
2) EEG system setup and operation will be practiced prior to conducting research on subjects.
3) Subjects will be asked periodically about any discomfort that they are experiencing, and
measures will be taken to try to mitigate any discomfort.
11. Explain how subjects' confidentiality will be protected. See Specific Ethical Criterion #5 in
Policy for the Use of Human Subjects in Research for a discussion of strategies for minimizing risks.
1) The confidentiality of the test subjects will be protected by replacing patient names with an
anonymous unique identifier consisting of a letter followed by the year that the subject
participated in the study (e.g. A15, B15, etc.). Any study documents and publications will
refer to patients by anonymous identifier only.
2) Although demographic information and EEG tracings may be published along with findings
from the study, the identity of subjects participating in the study will not be disclosed.
3) Paper copies of research paperwork, consent forms, and data with subjects’ information
will be stored in a locked cabinet.

29
12. Describe any incentives for participation that will be used. See Specific Ethical Criterion #2
in Policy for the Use of Human Subjects in Research for a discussion of the use of incentives in research.
Subjects who participate will be offered $25 from the MEDITEC budget to be used for purchase
of a meal.
13. Will deception of subjects be involved in the research procedures?
Yes* X No
*If so, explain the deception and how it will be handled. See Specific Ethical Criterion #3 in Policy
for the Use of Human Subjects in Research for a discussion of the use of deception in research:
14. Type of review requested:
Exempt from further review*
X Expedited review Full review
See Types of Review in Policy for the Use of Human Subjects in Research for a discussion of
the criteria for exempt, expedited, and full reviews.
*The research protocol submitted for a project presumed to be exempt may be abbreviated but should contain
sufficient information to support the conclusion that the project meets the criteria for exemption.
15. Signatures:
Your signature below indicates that the information presented in this application (the approval
form and research protocol) is accurate and that you have read, understand, and agree to follow
the Policy for the Use of Human Subjects in Research.
Name of Primary
Researcher:
Charlie Aylward
Signature:
Cal Poly Faculty Advisor's Signature (Required if this is student research)
I have reviewed this research proposal, which has been prepared by my advisee(s) in
accordance with the Guidelines for Obtaining Human Subjects Approval.
Name of Faculty Advisor: Kristen Cardinal
Signature
Return to the Human Subjects Committee homepage.

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